Equine Medicine

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Small colon impaction is a relatively infrequent cause of colic. However, when it does occur, it can be difficult to recognize and to manage. We have noticed over the last several years that many of these cases are initiated by diarrheal disease, making the eventual diagnosis of an obstructive condition unexpected by the veterinarian.

The use of underwater treadmill exercise for training and rehabilitation of horses has become increasingly popular in recent years. Many claims are made as to the usefulness of this form of exercise in horses; although relatively little published information is available to substantiate these assertions. In humans, underwater treadmill therapy has long been recognized for benefits in rehabilitation.

The epidemiology of R. equi remains ill-defined and continues to evolve. Two epidemiologic questions of clinical importance regarding Rhodococcus equi foal pneumonia are "Why are some foals affected while others in the same environment remain unaffected?", and "Why does the disease occur recurrently at some farms but not at others?". To answer these questions, studies performed at the level of the foal and farm, respectively, are needed.

The emergence of methicillin-resistant Staphylococcus aureus (MRSA) as a major human health concern has heightened awareness of the occurrence of this agent in companion animals, including horses. The purpose of this presentation is to review what basic knowledge equine practitioners should have regarding MRSA and other methicillin-resistant staphylococcal species in horses.

The major concern of any fracture repair is to maintain adequate stability for fracture healing to occur. The stability provided by open reduction and internal fixation (ORIF) is difficult to achieve with other methods of fracture repair. However, ORIF invades the fracture site, can lead to further disruption of vasculature and soft tissue and may provide a mechanism for infection to develop or persist.

Equine practitioners frequently deal with septic wounds, arthritis, osteomyelitis and tenosynovitis. The primary mechanisms of treatment should always include physical debridement and lavage. Most treatment regiment include systemic antimicrobials and antiinflammatories. A limiting factor in some cases is the ability to obtain effective concentrations of antimicrobials to the sites of infection or contamination.

Strangulation obstruction of the small intestine is frequently fatal because of simultaneous occlusion of the intestinal lumen and its blood supply, resulting in progressive necrosis of the mucosa, and development of endotoxemia. Among the more common causes of this condition are strangulating lipomas and entrapment within a natural internal opening or a mesenteric defect.

Critical appraisal of reports entails 3 fundamental steps: 1) determining if study results are valid; 2) assessing the clinical importance of study findings; and, 3) assessing if the results of valid, clinically important studies are relevant to our patients. A foundation for applying these 3 steps is a hierarchy of study types for EBM, which places a premium on those that are patient-based. Clinical importance has many interpretations, but in terms of quantification it is best assessed in reference to the magnitude of the observed association(s) in a study.

Among equids, R. equi infections occur almost exclusively among foaIs; infected adult horses generally have an underlying immunodeficiency, and human cases of R. equi are most commonly reported among persons infected with HIV or with other forms of immunosuppression such as that induced by drugs in transplant recipients and those receiving chemotherapy.